New Health Insurance Co-payment System Split Into 2 Stages 健保部分負擔新制2階推動 最快4月實施

The new health insurance co-payment system, which has been delayed since May last year, is finally on its way. Co-payment for emergency visits and medication will be implemented in April at the earliest. 

Some people go to the largest hospitals regardless of serious or minor illnesses. In order to change people's medical habits and implement tiered medical care, the National Health Insurance Administration announced that it will implement a new co-payment system in April at the earliest. The first to be affected is emergency room visits and outpatient medication. For example, if the triage classification is a mild case of level 4 or 5, the co-payment will be increased to NT$800 if a patient goes to a medical center's emergency room in the future. But if it is a severe case of level 1 or 2, the fee will be reduced to NT$300. Approximately one million people will be affected each year.

Shih Chung-liang, Director-General, NHIA: “About 1 million people will be affected in a year. And out of this 1 million people, about half of them are grade 1 or 2 in severity and will have their co-payment reduced.”

In terms of co-payment on outpatient medicines, clinics and district hospitals will maintain the status quo, and co-payment will be exempted for medication below NT$100. While medication above NT$101 will be charged in step-by-step intervals, with an upper limit of NT$200. As for continuous prescriptions for chronic diseases, if patients receive the medication at a clinic or a district hospital, they will be exempted from part of the co-payment three times. However, if patients receive such medication at a regional hospital or a medical center, they will be charged according to the level, with an upper limit of NT$300.

Lin Ya-hui, Executive Director, Taiwan Healthcare Reform Foundation: “Many multiple chronic disease patients will not only have medical prescription needs. They will also need regular inspections and other medical needs. And the costs accumulated over a year will be no small burden.”

As for the co-payment for inspections and exams, the NHIA emphasized that it will have a wide impact because it involves refunds and other supporting facilities. They need to further communicate with the medical community, the Healthcare Reform Foundation, the Consumers' Foundation, and other civic groups before deciding on the time for launch. 









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